急性胰腺炎患者凝血功能指标改变的临床意义

摘要

Objective To investigate the change of coagulation function in patients with a-cute pancreatitis and its clinical significance for prognosis.Methods 240 patients with acute pan-creatitis were divided in to moderate acute pancreatitis (MAP)group and severe acute pancreatitis (SAP)group (169 and 71,respectively),another 180 subjects underwent health examination dur-ing same period were selected into control group.Results Levels of APTT,INR,PT,TT,FIB and D-dimer in SAP group were higher than those in MAP group and control group (P <0.01);levels of AT-Ⅲ and PLT in SAP group were lower those in MAP and control group (P <0.01). The level of PT,APPT,D-dimer were positively correlated with APACHE Ⅱ score in SAP group (P <0.05),and level of AT-Ⅲ and PLT were negatively correlated with APACHE Ⅱ score (P <0.05).Conclusion Regular detection of coagulation functional change is potentially helpful for prognosis of patients with acute pancreatitis.%目的：探讨急性胰腺炎（AP）患者凝血功能指标改变的临床意义。方法选取本院消化科治疗的AP 患者240例，根据病情程度分为轻型胰腺炎组（MAP 组）169例和重型胰腺炎组（SAP 组）71例，对照组为同期本院体检健康者180例。检测3组的部分凝血活酶活化时间（APTT）、凝血酶原时间国际标准化指数（INR）、凝血酶原时间（PT）、凝血酶时间（TT）、纤维蛋白原（FIB）、D 二聚体（D-dimer）、抗凝血酶-Ⅲ（AT-Ⅲ）和血小板计数（PLT）水平。结果 SAP 组的 APTT、INR、PT、TT、FIB 及 D-dimer 均显著高于 MAP 组及对照组（P ＜0．01），AT-Ⅲ和 PLT 水平均显著低于 MAP 组及对照组（P ＜0．01）；SAP 组与 MAP组 APACHEⅡ评分比较差异有显著统计学意义（P ＜0．01）。SAP组的PT、APPT、D-dimer与APACHEⅡ评分呈正相关（P ＜0．05）；AT-Ⅲ活性、PLT 与 APACHEⅡ评分呈负相关（P ＜0．05）。结论 AP 患者的凝血功能改变与病情严重程度相关，相关指标测定可提高疾病预后判断准确性。